Spiny Papules in an Immunosuppressed Child

Trichodysplasia spinulosa is a rare folliculocentric polyomavirus infection observed in the setting of immunosuppression. We report a 7-year-old boy with pre-B-cell lymphoblastic leukemia who presented with folliculocentric spiny papules on the face. Histologic evaluation revealed hypertrophic bulbs, an expanded inner root sheath, and numerousbrightly eosinophilic trichohyalin granules. We present this case to raise awareness of this rare butrecognizable entity and to highlight the availability ofappropriate diagnostic and therapeutic modalities.